Evidence map›Paper›PMID 38879473›Full record

ArticleCardiovascular diabetology2024

Incident heart failure and the subsequent risk of progression to end stage kidney disease in individuals with type 2 diabetes.

Sylvia Liu, Jian-Jun Liu, Keven Ang, Janus Lee, Clara Chan, Resham L Gurung, Huili Zheng, Justin Tang, Su Chi Lim

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Sylvia Liu *Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Jian-Jun Liu *Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Keven AngClinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Janus LeeClinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Clara ChanClinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Resham L GurungClinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Huili ZhengClinical Research Unit, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Justin TangDepartment of Medicine, Khoo Teck Puat Hospital, Singapore, 768828, Singapore.
Su Chi LimSaw Swee Hock School of Public Heath, National University of Singapore, Singapore, 117549, Singapore. lim.su.chi@ktph.com.sg.

Funding

Singapore KTPH STAR grant 20201, 23201Singapore National Medical Research Council Grant MOH-000066, MOH-000714-01 and MOH-001327-02
6 · The paper itself

Abstract

backgroundDiabetic kidney disease is an established risk factor for heart failure. However, the impact of incident heart failure on the subsequent risk of renal failure has not been systematically assessed in diabetic population. We sought to study the risk of progression to end stage kidney disease (ESKD) after incident heart failure in Asian patients with type 2 diabetes.

methodsIn this prospective cohort study, 1985 outpatients with type 2 diabetes from a regional hospital and a primary care facility in Singapore were followed for a median of 8.6 (interquartile range 6.2-9.6) years. ESKD was defined as a composite of progression to sustained eGFR below 15 ml/min/1.73m2, maintenance dialysis or renal death, whichever occurred first.

results180 incident heart failure events and 181 incident ESKD events were identified during follow-up. Of 181 ESKD events, 38 (21%) occurred after incident heart failure. Compared to those did not progress to ESKD after incident heart failure (n = 142), participants who progressed to ESKD after heart failure occurrence were younger, had higher HbA1c and higher urine albumin-to-creatinine ratio at baseline. The excess risk of ESKD manifested immediately after heart failure occurrence, persisted for two years and was moderated thereafter. Cox regression suggested that, compared to counterparts with no heart failure event, participants with heart failure occurrence had 9.6 (95% CI 5.0- 18.3) fold increased risk for incident ESKD after adjustment for baseline cardio-renal risk factors including eGFR and albuminuria. It appeared that heart failure with preserved ejection fraction had a higher risk for ESKD as compared to those with reduced ejection fraction (adjusted HR 13.7 [6.3-29.5] versus 6.5 [2.3-18.6]).

conclusionIncident heart failure impinges a high risk for progression to ESKD in individuals with type 2 diabetes. Our data highlight the need for intensive surveillance of kidney function after incident heart failure, especially within the first two years after heart failure diagnosis.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionGlomerular Filtration RateHeart FailureKidneyKidney Failure, ChronicAgedBiomarkersFemaleHumansIncidenceMaleMiddle AgedPrognosisProspective StudiesBiomarkersEnd stage kidney diseaseHeart failureType 2 diabetes

Identifiers

PMID38879473
PMCPMC11180396

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.